When preparing for DIEP flap surgery or when weighing breast reconstruction options, knowing what to expect is important. DIEP flap reconstruction surgery uses the lower abdominal skin and fat to recreate a breast following breast cancer surgery.
What Is DIEP Flap Surgery and How Does It Work?
DIEP stands for Deep Inferior Epigastric Perforator, the blood vessels used to supply the abdominal tissue during reconstruction. The procedure preserves your abdominal muscles while using your body’s own tissue to form a new breast. This muscle-sparing approach supports faster recovery, better core strength retention, and long-lasting results.
DIEP Flap Surgery Step-by-Step Procedure
DIEP Flap surgery is performed in an inpatient setting, meaning the patient will stay in the hospital for a short time after the procedure. During the surgery, a football-shaped incision is made along the bikini line from hip to hip (like a tummy tuck incision). The skin, fat, and blood vessels removed from this incision are then transferred to the chest to create the new breast shape. An animation of the DIEP surgery process can be viewed here.
The transferred tissue is connected to the chest wall via microsurgery. Experienced surgeons use sutures as thin as human hair to attach the blood vessels from the abdominal tissue to the blood vessels in the chest.
Benefits of DIEP Flap vs. TRAM or Implants
Unlike the more commonly known TRAM flap, DIEP reconstruction does not use any abdominal muscles. This means DIEP patients can heal faster, maintain core strength, and experience fewer abdominal complications compared to TRAM flap patients.
See how each procedures compare:
| DIEP Flap | Tram Flap | Implants | |
| Tissue source | Patient’s lower abdominal skin and fat | Same as DIEP, but includes muscle | Silicone or saline implant |
| Feel & Look | Most natural | Natural, but muscle loss may affect shape | Less natural feel |
| Surgery Time | 4–6 hours | 6-8 hours | 1-2 hours |
| Hospital Stay | ~2 days | 4–5 days | 1 day |
| Recovery | 6–8 weeks | 8+ weeks | 2–4 weeks |
| Complication Risk | Low | Higher due to muscle involvement | Slight risk of implant failure |
| Longevity | Lifetime | Lifetime | May need replacement |
What to Expect During Hospital Stay After DIEP Flap
After the surgery is complete, patients will remain in the hospital for a few days. Thanks to PRMA’s ERAS protocol, most patients can go home after about 2 days following DIEP surgery. Patients at many other breast centers can plan to stay around 5 days. PRMA’s ERAS protocol has also been shown to improve the healing experience for patients. Since implementing the protocol, patients experience less pain and rarely find the need for narcotic pain medication use following surgery.
DIEP Flap Recovery Timeline: Weeks 1–6
DIEP flap recovery is progressive and empowering when patients are informed. Here’s a simplified timeline:
- Week 1: In the hospital under close monitoring
- Week 2: Light walking at home encouraged
- Weeks 3–4: Gradual return to routine tasks
- Week 6: Cleared for most normal activities
Typically, patients feel more like their pre-surgery selves following DIEP after six weeks. During the recovery period, patients will have drains for a short period of time. Special post-surgery bras and abdominal binders will also need to be worn for a short duration of time.
As with any surgery, recovery is not the same for everyone. Healing can take time, and patients must take the time they need to recuperate at their own pace.
Personalized DIEP Flap Surgery for Every Patient—Explore Your Options
At PRMA Plastic Surgery, DIEP flap breast reconstruction is more than a procedure—it’s part of a personalized care journey. Our San Antonio-based microsurgical experts perform over 700 advanced breast reconstructions each year, making PRMA one of the most experienced centers in the country.
From your first consultation through full recovery, you’ll be supported by a team that prioritizes your comfort, confidence, and long-term outcomes.
Ready to Take the Next Step?
If you’re considering DIEP flap breast reconstruction, PRMA is here to guide you every step of the way.
Schedule a consultation with our expert surgical team to explore your personalized options.
